Provider Demographics
NPI:1356723399
Name:TESTROET, MATTIE JOY (ARNP)
Entity type:Individual
Prefix:
First Name:MATTIE
Middle Name:JOY
Last Name:TESTROET
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MATTIE
Other - Middle Name:JOY
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3530 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-4503
Mailing Address - Country:US
Mailing Address - Phone:319-233-2701
Mailing Address - Fax:319-236-7993
Practice Address - Street 1:3530 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-4503
Practice Address - Country:US
Practice Address - Phone:319-233-2701
Practice Address - Fax:319-236-7993
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA122571363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner